Transcript Nutritional needs through life extension (5.80

Nutritional needs
through life
(Extension)
© BRITISH NUTRITION FOUNDATION 2013
Learning objectives
• To recognise the different key stages in
life.
• To understand why different amounts of
energy and nutrients are required through
life.
• To describe the needs of different life
stages to maintain health.
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Key stages in life
The key stages in life include:
• pregnancy;
• infancy;
• childhood;
• adolescence;
• adulthood.
Energy and nutrient
requirements change through
life and depend on many
factors, such as:
• age;
• sex;
• body size;
• level of activity.
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Pregnancy
A varied diet, providing adequate amounts of
energy and nutrients, is essential both before a
woman becomes pregnant (conception) and
during pregnancy.
The mother’s diet can influence the health of the
baby. Having a healthy body weight is important.
Being underweight can make it more difficult to
become pregnant and make it more likely for the
baby to have a low birth weight, leading to a
greater risk of ill health.
Did you know?
Being overweight increases the risk of
complications, such as high blood pressure and
diabetes during pregnancy.
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Conception and early
pregnancy – folate/folic acid
Folic acid is the synthetic form of
the B vitamin, folate. It is needed
for rapid cell division and growth
in the foetus that takes place
during pregnancy.
Folate has been shown to
reduce the chance of neural
tube defects (NTD), such as spina
bifida, in the unborn baby.
Foods that are good sources of
folate include green leafy
vegetables, oranges, bananas,
bread and fortified breakfast
cereals.
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Conception and early pregnancy –
folate/folic acid
Women who are trying to become
pregnant, or who are pregnant,
should take a 400 microgram (μg)
supplement of folic acid every day.
Women who are at a higher risk of an
NTD may need to take higher doses
as prescribed by their doctors.
They should start from the time they
stop using contraception until at least
the 12th week of pregnancy.
This is because it is difficult to achieve
the extra folate needed through diet
alone.
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During pregnancy
During pregnancy, some extra
nutrients are needed (mainly in
the last three months) to:
• help the development of the
uterus, placenta and other
tissues;
• meet the needs of the
growing foetus;
• lay down stores of nutrients
and energy (as fat) for the
growth of the foetus and in
the mother for lactation.
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During pregnancy
During the first 6 months of
pregnancy, most women do
not need to eat more than
normal.
The body becomes more
efficient at absorbing and
using nutrients from food.
The Estimated Average
Requirement (EAR) increases
during the last 3 months of
pregnancy by an average of
800kJ per day.
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Weight gain during pregnancy
On average, if a woman eats
to satisfy her appetite, her
weight will usually increase by
about 3.5kg in the first 20
weeks, then 0.5kg a week until
the end of pregnancy.
The total weight gain will be
about 10-14kg over the full
term.
Did you know?
Gaining too much weight can
raise the mother’s blood
pressure and increase her risk
of being overweight or having
diabetes.
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Food to avoid during pregnancy
Too much vitamin A during early pregnancy has
been linked to birth defects. Vitamin A rich foods
include liver and liver products, such as pâté,
vitamin A supplements and fish liver oils.
Unpasteurised cheese and cheeses with a soft rind,
such as Brie and Camembert, may be
contaminated by Listeria, which can cause a
miscarriage or infect the baby, so should not be
consumed.
Shark, swordfish and marlin. These types of fish may
contain high levels of mercury, which can harm an
unborn baby’s developing nervous system.
Pregnant women, and those who are trying to
conceive, are advised to stop drinking alcohol.
Alcohol may damage the unborn child.
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Food to avoid during pregnancy
To lower the risk of getting a foodborne illness,
pregnant women should avoid the following:
• ready-meals that are undercooked, particularly if
they contain poultry, or are not pre-heated before
consumption, e.g. quiches and cold meat pies;
• unwashed fruit and vegetables;
• raw or partially cooked eggs and products
containing raw eggs, e.g. homemade
mayonnaise;
• raw or undercooked meat (particularly poultry and
minced meat), including cured meat such as
parma ham and salami;
• contact of raw meat with products that are
consumed raw;
• unpasteurised milk and milk products (particularly
goat’s milk).
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To watch the e-seminar Nutrition in Pregnancy
click the link below.
© BRITISH NUTRITION FOUNDATION 2013
Breastfeeding / lactation
The process of producing
breast milk and delivering it to
the baby is called lactation.
The extra EAR for energy during
lactation is 1400kJ per day in
the first six months.
There are also increased
demand for nutrients, such as
calcium, phosphorous, vitamins
A and C.
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Breast milk
On average, 100g of breast milk
provides:
• 289kJ energy
• 1.3g protein
• 4.1g fat
• 7.2g carbohydrate
• 34mg calcium
Breast milk provides special
proteins, antibodies and white
blood cells, which help to
protect the baby against
infection.
It also provides growth factors
and hormones, important for the
healthy growth and
development of the baby.
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Bottle feeding
Some women are unable to or
choose not to breastfeed their
baby. Their midwife or health
visitor will be able to give
information on preparing and
feeding the baby with infant
formula.
Infant formula (also known as
‘baby milk’) does not provide any
of the factors that help prevent
infections.
It is important to note that once a
mother has started to bottle feed
her baby, it is difficult to change
to breast feeding.
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Weaning
After 4 to 6 months of age, milk
no longer fulfils all the baby’s
needs for energy and nutrients.
The baby must be given other
foods in addition to breast milk
or infant formula. This process is
called weaning.
Weaning before this age is not
recommended, as the
intestines and kidneys may not
be able to process the food.
Solids must be semi-fluid and
soft, since the baby has no
teeth and cannot chew.
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Weaning
Infants under 6 months should not be given:
• wheat or other cereals that contain the protein
gluten to avoid a possible allergic reaction to
gluten, called coeliac disease;
• raw eggs and foods that contain raw or partially
cooked eggs due to the risk of food poisoning from
Salmonella (eggs should be cooked until both the
white and yolk are solid);
• foods with added salt because their developing
kidneys are unable to handle the salt;
• honey (risk of botulism poisoning), deep sea fish
such as shark, marlin and swordfish (potential of
high mercury levels) and whole nuts (risk of
choking).
Did you know?
Sugar-containing foods and drinks (e.g. biscuits, some
rusks, fruit juices) between meals should be limited.
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Weaning
Supplements of vitamins A, C and D in
the form of drops are recommended for
children aged from 6 months to 5 years.
This is particularly important if they do not
eat a varied diet. For some, these are
available free via the Healthy Start
scheme.
Cows’ milk is not suitable as a drink
before 12 months of age because it is
low in iron, but can be used in small
amounts in cooking from 6 months.
Low-fat varieties of milk, as a main drink,
are not suitable for babies and young
children until at least 2 years of age.
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To watch the e-seminar Weaning click the link
below.
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Childhood
Children should be
encouraged to eat a variety of
foods from each of The eatwell
plate’s four main food groups:
fruit and vegetables;
bread, rice, potatoes, pasta
and other starchy
foods;
• milk and dairy foods;
• meat, fish, eggs, beans and
other non-dairy
sources of protein.
•
•
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Childhood
Children have a higher energy
requirement for their body size
compared to adults because they are
growing rapidly and are often very
active.
A nutrient-dense diet providing
adequate energy and nutrients, which
includes healthy snacks, is essential for
growth and development. It is also
important for children to have sufficient
to drink.
Young children also have small
stomachs so they need to eat small
and frequent meals.
© BRITISH NUTRITION FOUNDATION 2013
Toddlers (up to 5 years)
Supplements of vitamins A, C and D in the
form of drops are recommended for children
aged from 6 months to 5 years. This is
particularly important if they do not eat a
varied diet. For some, these are available
free via the Healthy Start scheme.
Semi-skimmed milk (as a main drink) can be
gradually introduced when the child reaches
2 years if they are having a healthy, varied
diet; but 1% or skimmed milk should not be
given as a main drink until the child reaches
5 years.
Young children should not be given whole
nuts (risk of choking) and deep sea fish such
as shark, marlin and swordfish (potential for
high mercury levels).
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Childhood
Childhood is an important time for
growth and development.
Children need a good supply of
protein, and other nutrients
including calcium, iron and
vitamins A and D.
Children begin to take responsibility
for their own food choices around
this time. It is therefore important to
encourage them to eat a healthy,
varied diet which is rich in fruit,
vegetables and starchy foods.
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Childhood
Children should be
encouraged to remain a
healthy weight with respect to
their height.
A healthy family lifestyle can
help to maintain a healthy
weight, such as being active
together or sharing meals.
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Childhood
Dental hygiene is very
important. Children should pay
attention to dental hygiene
and ways to prevent dental
caries.
Teeth should be brushed twice
a day with a fluoridecontaining toothpaste.
Sugar-containing foods and
drinks should be limited to meal
times.
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Adolescence
Adolescence is a period of rapid growth and
development and is when puberty occurs.
The demand for energy and most nutrients are
relatively high.
• Boys need more protein and energy than girls
for growth.
• Girls need more iron than boys to replace
menstrual losses.
It is important to encourage an active lifestyle
with a healthy, balanced diet during this time.
This is because good habits practised now are
likely to benefit their health for the rest of their
lives.
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Adolescence
A growth spurt begins around
10 years of age in girls and 12
years in boys.
In both sexes, an average of 23
cm is added to height and 20
to 26kg in weight.
Before adolescence, both girls
and boys have an average of
18% body fat.
During adolescence, this
increases to around 28% in girls
and decreases to around 15%
in boys.
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Adolescence – iron
Teenage girls and women require
14.8mg of iron each day.
Teenage boys need 11.3mg of iron
daily and this reduces to 8.7mg for
men aged 19 or over.
Iron from meat sources, is readily
absorbed by the human body.
Did you know?
Vitamin C helps to absorb iron from
non-meat sources, such as green leafy
vegetables, nuts, pulses, dried fruits,
wheat flour and breakfast cereals.
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Adulthood
Nutritional requirements do not
change much between the
ages of 19 to 50, except during
pregnancy and lactation.
On average, UK adults are
eating too much saturated fat
and salt from food, and not
enough fruit and vegetables.
A poor diet can lead to diseases
such as obesity, cardiovascular
diseases, cancer and diabetes.
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Adulthood
To reduce the risk of
developing these diseases, it is
important to:
• eat a balanced diet with
plenty of fruit and
vegetables;
• opt for healthier fats;
• get enough dietary fibre;
• keep well hydrated;
• stay active;
• drink alcohol in moderation;
• not smoke.
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Healthy weight for adults
Adults should aim for a healthy body weight for
their height and try to keep it at that level.
The Body Mass Index (BMI) is an indicator of
whether a person is underweight, overweight or a
healthy weight.
To calculate BMI (kg/m2), divide weight (kg) by
height (m) x height (m).
BMI =
weight (kg)
height (m) x height (m)
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Recommended BMI range
Underweight
Normal
Overweight
Obese
Very obese
less than 18.5
18.5 - less than 25
25 - less than 30
30 - 40
over 40
Can you work out the BMI?
William
Jane
Height: 1.75m
Height: 1.56m
Weight: 80kg
Weight: 48kg
weight (kg)
BMI =
height (m) x height (m)
= 26.1
(overweight)
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= 19.7
(normal)
To watch the e-seminar Energy – a balancing act
click the link below.
© BRITISH NUTRITION FOUNDATION 2013
Waist circumference measurement
Waist circumference measurement is
also an indicator of whether a person
has a healthy body weight.
Abdominal or visceral fat (i.e. fat
carried around the waist) is known to
be a greater risk to health than weight
carried on other parts of the body.
Waist measurements should be below:
80 cm (31.5 in) for all women
94 cm (37 in) for men (black and white)
90 cm (35 in) for Asian men
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Older adults
Requirements for energy
gradually decrease after the
age of 50 as activity level falls.
Older adults is the term usually
referring to people over the
age of 65.
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Older adults
Older people may eat less for
different reasons, for example:
• difficulty in chewing and
swallowing;
• dental problems;
• changes in sense of smell
and taste;
• difficulty in shopping,
preparing and cooking
food;
• living alone;
• financial problems;
• illness.
© BRITISH NUTRITION FOUNDATION 2013
Older adults
To maintain good health, it is
important that older adults:
• enjoy their food;
• keep active;
• have adequate nutrient
intakes.
Older adults should adopt a
healthy, balanced diet to
maintain health.
It is also important they keep
hydrated by drinking plenty of
fluid. Even minor dehydration
may lead to health problems.
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Older adults
After menopause (when menstruation
stops), women lose bone strength at
an increased rate. Having a great
peak bone mass (PBM) in early
adulthood helps adults to start from a
higher point from which bones will be
lost during the ageing process.
Older adults should have plenty of
calcium intake from the diet, but also
remain active and have adequate
vitamin D from foods, or through the
action of sunlight on the skin. Adults
over 65 years who are housebound
should take a daily supplement of
vitamin D as skin synthesis of this
vitamin requires sunshine.
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Summary
There are various key stages in
life of importance nutritionally:
pregnancy, infancy,
childhood, adolescence,
adulthood and older
adulthood.
Differing amounts of energy
and nutrients are required at
different life stages.
It is important to maintain a
healthy weight throughout life
by eating a healthy diet and
taking regular physical activity.
© BRITISH NUTRITION FOUNDATION 2013
Question
Which list of foods can be
eaten during pregnancy?
Pâté, Brie and raw shellfish
Liver, homemade
mayonnaise and Stilton
Cod, herbal tea and hard
boiled eggs
Swordfish, unpasteurised
milk and Parma ham
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Wrong answer.
Try again
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Next
question
Correct answer.
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Next
question
Question
Which type of milk is suitable as
a main drink for babies and
young children aged 1 to 2
years of age?
1%
skimmed
semi-skimmed
whole
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Wrong answer.
Try again
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Next
question
Correct answer.
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Next
question
Question
True or false?
Children have a relatively high
energy requirement for their
size because they are growing
rapidly and are often very
active.
True
False
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True. Children have a relatively
high energy requirement for
their size because they are
growing rapidly and are often
very active.
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Next
question
Question
Which group of supplements is
recommended in the form of
drops for children aged 6
months to 5 years?
Zinc and iron
Vitamins A, C and D
B vitamins
Sodium and magnesium
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Wrong answer.
Try again
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Next
question
Correct answer.
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Next
question
Question
True or false?
Compared with
recommendations, on average
UK adults consume lower levels
of saturated fat, added sugars
and salt, and higher than
recommended amounts of fruit
and vegetables and oily fish.
True
False
© BRITISH NUTRITION FOUNDATION 2013
False. Compared with
recommendations, on average
UK adults consume higher
levels of saturated fat, added
sugars and salt, and lower than
recommended amounts of fruit
and vegetables and oily fish.
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Next
question
Question
Which of the following is likely
to happen to older women
after menopause?
Decrease in blood
cholesterol levels
Decrease in blood pressure
Increase in bone loss
Increase in hair growth
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Wrong answer.
Try again
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The end
Correct answer.
The end
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British Nutrition Foundation
Imperial House
15-19 Kingsway
London WCB 6UN
Telephone: 020 7557 7930
Email: [email protected]
Web: www.nutrition.org.uk www.foodafactoflife.org.uk
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